Masato Fujisawa

Kobe University, Kōbe, Hyōgo, Japan

Are you Masato Fujisawa?

Claim your profile

Publications (605)1587.51 Total impact

  • No preview · Article · Mar 2016 · Medical Oncology
  • Koji Chiba · Noritoshi Enatsu · Masato Fujisawa
    [Show abstract] [Hide abstract]
    ABSTRACT: Non-obstructive azoospermia (NOA) is defined as no sperm in the ejaculate due to failure of spermatogenesis and is the most severe form of male infertility. The etiology of NOA is either intrinsic testicular impairment or inadequate gonadotropin production. Chromosomal or genetic abnormalities should be evaluated because there is a relatively high incidence compared with the normal population. Although rare, NOA due to inadequate gonadotropin production is a condition in which fertility can be improved by medical treatment. In contrast, there is no treatment that can restore spermatogenesis in the majority of NOA patients. Consequently, testicular extraction of sperm under an operating microscope (micro-TESE) has been the first-line treatment for these patients. Other treatment options include varicocelectomy for NOA patients with a palpable varicocele and orchidopexy if undescended testes are diagnosed after adulthood, although management of these patients remains controversial. Advances in retrieving spermatozoa more efficiently by micro-TESE have been made during the past decade. In addition, recent advances in biotechnology have raised the possibility of using germ cells produced from stem cells in the future. This review presents current knowledge about the etiology, diagnosis, and treatment of NOA.
    No preview · Article · Jan 2016 · Reproductive Medicine and Biology
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Rotavirus infections are a major cause of diarrhea in children in both developed and developing countries. Rotavirus genetics, patient immunity, and environmental factors are thought to be related to the severity of acute diarrhea due to rotavirus in infants and young children. The objective of this study was to provide a correlation between rotavirus genotypes, clinical factors and degree of severity of acute diarrhea in children under 5 years old in Surabaya, Indonesia. A cross-sectional study was conducted in children aged 1-60 months with acute diarrhea hospitalized in Soetomo Hospital, Surabaya, Indonesia from April to December 2013. Rotavirus in stool specimens was identified by ELISA and genotyping (G-type and P-type) using multiplex reverse transcription PCR. Severity was measured using the Ruuska and Vesikari scoring system. The clinical factors were investigated included patient's age (months), hydration, antibiotic administration, nutritional state, co-bacterial infection and co-viral infection. A total of 88 children met the criteria; 80.7% were aged 6-24 months, watery diarrhea was the most common type (77.3%) and 73.6% of the subjects were co-infected with bacteria, of which pathogenic Escherichia coli was the most common (42.5%). The predominant VP7 genotyping (G-type) was G2 (31.8%) and that of VP4 genotyping (P-type) was P[4] (31.8%). The predominant rotavirus genotype was G2P[4] (19.3%); G1P[4] and G9P[4] were uncommon with a prevalence of 4.5%. There were significant differences between the common genotype and uncommon genotype with respect to the total severity score of diarrhea (p <0.05). G3, G4 and G9 were significantly correlated with severe diarrhea (p = 0.009) in multivariate analyses and with frequency of diarrhea (>10 times a day) (p = 0.045) in univariate analyses, but there was no significant correlation between P typing and severity of diarrhea. For combination genotyping of G and P, G2P[4] was significantly correlated with severe diarrhea in multivariate analyses (p = 0.029). There is a correlation between rotavirus genotype and severity of acute diarrhea in children. Genotype G2P[4] has the highest prevalence. G3, G4, G9 and G2P[4] combination genotype were found to be associated with severe diarrhea.
    Full-text · Article · Dec 2015 · Gut Pathogens
  • Noritoshi Enatsu · Koji Chiba · Masato Fujisawa
    [Show abstract] [Hide abstract]
    ABSTRACT: Surgical sperm extraction with intracytoplasmic sperm injection has become widespread worldwide and is regarded as the sole option for patients with azoospermia. However, the sperm retrieval rate remains unsatisfactorily low, particularly for men with non-obstructive azoospermia (NOA). Therefore, the technical challenges associated with improving the sperm retrieval rate for men with NOA are being addressed. The most successful method developed to date is microdissection testicular sperm extraction (micro-TESE), which is rapidly becoming recognized as a useful technique due to its relatively high sperm retrieval rate and low complication rate. However, even with micro-TESE, the sperm retrieval rate for men with NOA remains at 30–60 %, with an even lower birth rate. The technical challenges associated with improving the outcomes of surgical sperm extraction are being approached through the use of ultrasound and optimal surgical devices such as narrow band imaging, multiphoton microscopy, and optical coherent tomography. In addition to the difficulties related to searching for sperm, medical treatments that induce spermatogenesis remain controversial. For example, varicocele repair prior to surgical sperm extraction and hormonal therapy before and after TESE have been extensively examined. We herein briefly summarized the development process in surgical sperm extraction up to the present and technical challenges to improve the outcomes of surgical sperm extraction.
    No preview · Article · Nov 2015 · Reproductive Medicine and Biology
  • Katsumi Shigemura · Masato Fujisawa

    No preview · Article · Nov 2015 · International Journal of Urology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Impairment of renal function is a serious issue that should be considered in patients undergoing treatment with molecular-targeted agents for metastatic renal cell carcinoma (mRCC). Aims The objective of this study was to assess the impact of molecular-targeted therapy on changes in renal function among patients with mRCC. Patients and Methods The study included 408 mRCC patients treated with sunitinib, sorafenib, axitinib, everolimus and/or temsirolimus. Among these, 185, 128 and 95 received molecular-targeted agents as first-line (group 1), second-line (group 2) and third-line (group 3) therapy, respectively. Results No significant differences between the estimated glomerular filtration rate (eGFR) at baseline and that at the end of molecular-targeted therapy were noted among the three groups of patients. In addition, there were no significant differences between eGFR prior to the introduction of molecular-targeted therapy and that at the end of therapy across agents and lines of targeted therapy, with the exception of patients treated with axitinib and everolimus in second-line and third-line therapy, respectively. In group 1, a reduction in eGFR of >10 % from baseline was independently associated with performance status, hypertension and treatment duration, while in groups 2 and 3, only treatment duration was independently related to a reduction in eGFR of >10 %. Conclusions It appears that renal function in patients with mRCC is not markedly impaired by molecular-targeted therapies, irrespective of the specific agents introduced; however, it may be necessary to pay special attention to deterioration in renal function when molecular-targeted therapy is continued for longer periods.
    No preview · Article · Oct 2015 · Targeted Oncology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: The objective of this study was to investigate clinical outcomes in patients undergoing selective versus conventional complete renal arterial clamping during robot-assisted partial nephrectomy (RAPN). Methods: This study included 19 patients with renal tumors who received RAPN incorporating selective arterial clamping (group 1). The renal functional as well as perioperative outcomes in group 1 were compared with those in 20 patients with renal tumors undergoing RAPN with total clamping of the renal artery (group 2) during the same period. Results: In group 1, tumor resection under selective arterial clamping could be completed in all patients without intraoperative conversion to conventional RAPN with total clamping. There were no significant differences in the tumor size, RENAL nephrometry score, or preoperative estimated glomerular filtration rate (eGFR) between groups 1 and 2. Furthermore, no significant differences were noted in the estimated blood loss, operative time, or warm ischemia time between the 2 groups. Although there was no significant difference in the rate of decrease in eGFR 4 weeks after RAPN between the 2 groups, the rate of decrease in eGFR 1 week after RAPN in group 1 was significantly lower than that in group 2. The choice of selective or total clamping was also identified as an independent predictor of a postoperative decrease in eGFR by > 10% at 1 week, but not 4 weeks, after RAPN. Conclusions: A precise segmental clamping technique is feasible and safe for performing RAPN, resulting in an improved postoperative renal function, particularly early after surgery.
    No preview · Article · Oct 2015 · Surgical Innovation
  • Source
    Noritoshi Enatsu · Hideaki Miyake · Koji Chiba · Masato Fujisawa
    [Show abstract] [Hide abstract]
    ABSTRACT: Nephrin and podocin are known to be closely related to the pharmacological effects of angiotensin-II receptor blocker (ARB). The objectives of this study were to investigate the role of nephrin and podocin using cisplatin-induced testicular damage and to evaluate the effect of ARB. At first, we evaluated the effects of cisplatin either alone or in combination with ARB candesartan on changes in expression patterns of nephrin and podocin in the rat testes. We then conducted in vitro studies to investigate the effects of angiotensin using cultured Sertoli cells, line TM4. As a result, the expression of nephrin and podocin was shown to localize around the basal membrane of seminiferous tubules. Treatment with cisplatin resulted in a marked decrease in the expression of nephrin and podocin and induced a shift of both proteins from linear to granular expression patterns, accompanying the increased apoptotic index in the testes; these changes were partially restored by the additional administration of candesartan. In vitro studies with TM4 revealed the angiotensin-II mediated expression changes of nephrin and podocin. These findings suggest that candesartan can prevent cisplatin-induced testicular damage by regulating expression patterns of the nephrin-podocin complex in the testes.
    Preview · Article · Oct 2015
  • [Show abstract] [Hide abstract]
    ABSTRACT: Prognostic significance of early tumor shrinkage following treatment with tyrosine kinase inhibitors (TKIs) in patients with metastatic renal cell carcinoma (mRCC) has not been fully elucidated. The aim of this study was to assess the impact of early tumor shrinkage induced by first-line TKIs on overall survival (OS) in mRCC patients. This study retrospectively included 185 consecutive Japanese patients with mRCC treated with either sunitinib or sorafenib for at least 3 months as first-line molecular-targeted therapy between April 2011 and December 2014 at Kobe University Hospital and its affiliated institutions. Median OS in the 185 patients was 33.6 months. At 12 weeks after the introduction of TKIs, 9 patients had achieved tumor shrinkage from -100 to -50 %, 43 from -49 to -25 %, 61 from -24 to 0 %, and the remaining 72 patients showed an increase in tumor size. The median OS stratified according to tumor shrinkage as shown above was 59.2, 39.1, 31.4, and 16.1 months, respectively. Univariate analysis identified prior nephrectomy, Memorial Sloan Kettering Cancer Center (MSKCC) risk classification, C-reactive protein (CRP) level, liver metastasis, number of metastatic organs, histological subtype, sarcomatoid feature, and early tumor shrinkage as significant predictors of OS. Of these significant factors, only the MSKCC classification, CRP level, liver metastasis, and early tumor shrinkage were shown to be independently associated with OS on multivariate analysis. Early tumor shrinkage could be a useful predictor of OS in mRCC patients receiving TKIs as a first-line molecular-targeted agent.
    No preview · Article · Sep 2015 · Targeted Oncology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Signal transducer and activator of transcription (STAT)3 is a reported mediator of molecular-targeted drug-induced keratinocyte toxicity. Our purpose was to assess the association of single nucleotide polymorphisms (SNPs) in STAT3 with hand-foot skin reactions (HFSR) in patients with metastatic renal cell carcinoma (mRCC) treated with multiple tyrosine kinase inhibitors (mTKIs). Sixty-five Japanese patients with clear cell renal cell carcinoma who were treated with any mTKI at Kobe University Hospital were retrospectively genotyped to elucidate a potential association between STAT3 polymorphisms and HFSR development. The final analysis included 60 patients. HFSR was observed in 46 patients. The GG, GC, and CC genotypes at rs4796793 were found in 9, 27, and 24 patients, respectively. Three other STAT3 polymorphisms exhibited tight linkage disequilibrium with rs4796793. A significant association was found between the rs4796793 allele and HFSR [G vs. C; odds ratio [OR], 4.33; 95 % confidence interval [CI], 1.80-10.45; P = 0.001]. The GG genotype had the highest OR compared with GC + CC genotypes (OR, 10.75; 95 % CI, 2.38-48.07; P = 0.001). In a time-to-event Kaplan-Meier analysis, a statistically significant difference was observed between the GC + CC and the GG genotypes (P = 0.009). The rs4796793 genotype appears to be a novel factor for mTKI-induced HFSR in patients with mRCC. Prospective translational trials with larger numbers of patients are required to confirm our results. This research suggests a potential benefit of STAT3 polymorphism screening in patients treated with mTKIs.
    No preview · Article · Aug 2015 · Targeted Oncology
  • [Show abstract] [Hide abstract]
    ABSTRACT: According to the classical ladder theory, the mesonephric arteries (MAs) have a segmental arrangement and persist after regression of the mesonephros, with some of these vessels becoming definitive renal arteries. To avoid interruption of blood flow, such a vascular switching would require an intermediate stage in which two or more segmental MAs are connected to a definitive renal artery. To examine developmental changes, especially changes in the segmental distribution of MAs, we studied serial paraffin sections of 26 human embryos (approximately 5-7 weeks). At 5-6 weeks, 1-2 pairs of MAs ran anterolaterally or laterally within each of the lower thoracic vertebral segments, while 2-5 pairs of MAs were present in each of the lumbar vertebral segments, but they were usually asymmetrical. The initial metanephros, extending along the aorta from the first lumbar to first sacral vertebra, had no arterial supply despite the presence of multiple MAs running immediately anterior to it. Depending on increased sizes of the adrenal and metanephros, the MAs were reduced in number and restricted in levels from the twelfth thoracic to the second lumbar vertebra. The elimination of MAs first became evident at a level of the major, inferior parts of the metanephros. Therefore, a hypothetical arterial ladder was lost before development of glomeruli in the metanephros. At 7 weeks, after complete elimination of MAs, a pair of symmetrical renal arteries appeared near the superior end of the metanephros. In conclusion, the MAs appear not to persist to become a definitive renal artery. Copyright © 2015 Elsevier GmbH. All rights reserved.
    No preview · Article · Aug 2015 · Annals of anatomy = Anatomischer Anzeiger: official organ of the Anatomische Gesellschaft
  • Masatomo Nishikawa · Hideaki Miyake · Liu Bing · Masato Fujisawa
    [Show abstract] [Hide abstract]
    ABSTRACT: To analyze basal expression levels of multiple components in the autophagy pathway in radical nephrectomy specimens from patients with metastatic renal cell carcinoma (mRCC) treated with mammalian target of rapamycin (mTOR) inhibitors, to identify factors predicting susceptibility to these agents. This study included 48 consecutive patients undergoing radical nephrectomy, who were diagnosed with mRCC and subsequently treated with either everolimus or temsirolimus. Expression levels of 5 major molecular markers involved in the signaling pathway associated with autophagy, including autophagy-related protein (Atg)5, Atg9, Beclin1, microtubule-associated protein light chain 3, and UNC-51-like kinase 1 (ULK1), were measured by immunohistochemical staining of primary renal cell carcinoma specimens. During the observation period of this study (median = 16.2mo), 36 patients developed disease progression, with a median progression-free survival (PFS) period of 7.6 months. Of several factors examined, bone metastasis, liver metastasis, and ULK1 expression were shown to have significant effects on the response to mTOR inhibitors. PFS was significantly correlated with the expression level of ULK1 in addition to bone and liver metastases on univariate analysis. Of these significant factors, ULK1 expression and liver metastasis were independently associated with PFS on multivariate analysis. It may be useful to consider expression levels of potential molecular markers in the autophagy pathway, particularly ULK1, in addition to conventional parameters, when selecting patients with mRCC who are likely to benefit from treatment with mTOR inhibitors. Copyright © 2015 Elsevier Inc. All rights reserved.
    No preview · Article · Aug 2015 · Urologic Oncology
  • [Show abstract] [Hide abstract]
    ABSTRACT: To improve understanding of the variations of bladder neck musculature, we investigated histological changes of the bladder neck associated with prostatic hyperplasia in adult male cadavers. We examined histological sections from 24 donated male cadavers with a mean age of 74 years. The sections were subjected to Azan staining and to immunohistochemical staining using desmin and S-100 antibodies. The collagen content per cross-sectional area was calculated and statistically compared. Existence of three muscle layers (submucosal longitudinal muscles, circular bladder neck muscles, and external longitudinal muscles) was confirmed at both the anterior and posterior regions of the bladder neck. An increase of prostate volume was significantly correlated with an increase of collagen fibers and thinning of muscle bundles in the anterior bladder neck. Both an increase of prostate volume and increasing age were significantly correlated with degeneration of the posterior bladder neck muscles. As prostatic hyperplasia advanced, the bladder neck muscles were progressively affected by fibrosis, with the circular muscle fibers becoming thin and fragmented. In addition, the severity of fibrosis associated with prostatic hyperplasia showed interindividual variation. We also devised a schematic classification of bladder neck morphology in adult men. Degeneration of muscle bundles in the bladder neck of adult males with prostatic hyperplasia was confirmed, and it was found that the bundles became thinner along with an increase of collagenous tissue. Our schematic classification of bladder neck morphology in adult men may be useful for further investigations. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
    No preview · Article · Aug 2015 · The Journal of urology
  • [Show abstract] [Hide abstract]
    ABSTRACT: To characterize the changes in seminogram findings in infertile men after varicocelectomy. This study included 71 consecutive infertile men who underwent microsurgical low ligation varicocelectomy and received 3 semen analyses, 1 before microsurgical varicocelectomy and again at 3 and 12 months after. Total motile sperm count (TMSC) was calculated using the following formula: [volume (mL) × concentration (millions/mL) × motility (%)]. Despite the lack of significant changes in the proportion of sperm with abnormal morphology, sperm concentration, motility, and TMSC in the 71 patients were significantly higher at 3 and 12 months after varicocelectomy than before surgery. However, no further improvement in these parameters at 12 months after varicocelectomy was noted compared with those at 3 months. Furthermore, when the included men were divided into 3 groups according to preoperative TMSC as <3 million, 3-9 million, and >9 million, TMSCs at 3 months after varicocelectomy in all 3 groups were significantly higher than those before varicocelectomy; however, TMSCs at 12 months after surgery in all groups were similar to those at 3 months. The level of improvement in semen parameters at 3 months after varicocelectomy may be stable at 12 months after surgery, irrespective of baseline values of TMSC. Therefore, varicocelectomy could be offered as a therapeutic option for infertile men, even for couples with an older woman, because its efficacy is evaluable at 3 months after surgery, and assisted reproductive technology could be immediately applied to ineffective cases. Copyright © 2015 Elsevier Inc. All rights reserved.
    No preview · Article · Jul 2015 · Urology

  • No preview · Article · Jul 2015 · Journal of chemotherapy (Florence, Italy)
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: A kidney transplant case with de novo donor-specific antibody showed monoclonal plasma cell infiltration into the graft with ABO incompatibility. Three years after transplantation, the patient's graft function suddenly deteriorated. Interstitial edema and the predominant infiltration of inflammatory plasma cells with kappa chain monoclonality were observed in biopsy specimens. The in situ hybridization of Epstein-Barr virus was negative and post-transplant lymphoproliferative disorder was not evident from radiological examinations. On laboratory examination, the patient had de novo donor-specific antibody for HLA-DQ. We suspected plasma cell-rich acute rejection for which methylprednisolone pulse therapy, plasma exchange, rituximab, and 15-deoxyspergualin were given. In the ensuing biopsy, the degree of plasma cell infiltration was similar to the first biopsy; however, kappa chain monoclonality relatively weakened. Owing to resistance to these treatments, intravenous immunoglobulin (IVIG) (0.5 g/kg/day) was added. The serum creatinine level gradually declined to 3.1 mg/dL; however, it increased up to 3.6 mg/dL again. In the final biopsy, the infiltrated plasma cells disappeared but severe interstitial fibrosis developed. This case showed difficulty in the diagnosis and treatment of plasma cell-rich acute rejection. A detailed consideration of this case may be helpful in understanding the clinical features and pathogenesis of this condition. © 2015 Asian Pacific Society of Nephrology.
    Full-text · Article · Jul 2015 · Nephrology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: The objective of this study was to retrospectively review oncological outcomes in patients with stage I testicular germ cell tumor (GCT). Patients and Methods: This study included 265 consecutive Japanese men undergoing orchiectomy for stage I testicular GCT, and a retrospective review of their records was performed. Results: Of these 265 patients, 192 and 73 were pathologically classified with seminoma and nonseminoma, respectively. Prophylactic radiation and chemotherapy were performed in 62 patients with seminoma and 6 with nonseminoma, respectively. Disease recurrence occurred in 12 seminoma patients, of whom 11 had not received prophylactic radiation therapy; however, all 12 achieved a complete response to bleomycin, etoposide and cisplatin therapy. Of the nonseminoma patients, 19 experienced disease recurrence and were then treated with bleomycin, etoposide and cisplatin followed additionally by the surgical resection of residual tumors and salvage chemotherapy in 7 and 4, respectively. There was no cancer-specific death in the 265 patients, and 5-year recurrence-free survival rates in patients with seminoma and nonseminoma were 92.6 and 72.8%, respectively. Furthermore, following factors appeared to be significantly associated with recurrence-free survival in these patients: age, T classification, microvascular invasion and adjuvant therapy for those with seminoma, and microvascular invasion for those with nonseminoma. Conclusions: Despite a generally favorable prognosis in Japanese men with stage I testicular GCT, intensive follow-up or prophylactic therapy should be considered for men with possible risk factors of disease recurrence.
    No preview · Article · Jul 2015 · Current Urology
  • Hiromoto Tei · Hideaki Miyake · Ken-ichi Harada · Masato Fujisawa
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: To analyze the diagnostic performance of 12-core biopsy in detecting significant prostate cancer (PCa). Patients and Methods: This study included 206 PCa patients who underwent transrectal 12-core biopsy followed by radical prostatectomy. Radical prostatectomy specimens were anatomically divided into 12 areas according to the sampling cores, and the existence of significant cancer, defined by a tumor volume > 0.5 ml, was investigated. The detection rate of significant cancer in each area was calculated as follows: the number of positive core biopsies/the number of areas containing significant cancer × 100. Results: The overall detection rate of significant cancer in all areas was 53.6%. The detection rate was significantly higher in the standard sextant cores than in the additional 6 cores in patients with prostate-specific antigen ≥ 10 ng/ml, clinical stage ≥ T2, or biopsy Gleason score ≥ 7, but not in those with prostate-specific antigen Conclusions: Approximately half of the significant cancers were not accurately detected, and the detection rates in biopsy cores other than the sextant cores appeared to be significantly lower in PCa patients with aggressive features.
    No preview · Article · Jul 2015 · Current Urology
  • Masatomo Nishikawa · Hideaki Miyake · Masato Fujisawa
    [Show abstract] [Hide abstract]
    ABSTRACT: To analyze the clinical outcomes of the irinotecan plus nedaplatin (IN) regimen in patients with advanced germ cell tumors (GCTs) refractory to cisplatin-based combination chemotherapies. This study included a total of 20 consecutive advanced GCT patients who were categorized into intermediate- or poor-risk GCT groups according to the International Germ Cell Consensus Classification, and were judged to show refractory or relapsed disease after bleomycin, etoposide and cisplatin and cisplatin, ifosfamide and paclitaxel therapies. All 20 patients subsequently received IN therapy (irinotecan 100 mg/m(2) on days 1 and 15; nedaplatin 100 mg/m(2) on day 1) every 4 weeks. Following a median of 3 cycles of IN, 9 patients (45 %) achieved normalization of serum tumor markers. In addition, surgical resection of the residual tumors following IN was performed in 5 patients, of whom 4 were pathologically diagnosed with no viable cancer cells. At a median follow-up of 9 months, 11 patients (55 %) were alive, including 7 (35 %) with no evidence of disease, whereas the remaining 9 (45 %) died of disease progression. The median duration of overall survival after the introduction of IN to these 20 patients was 13.4 months. Severe hematological toxicities were observed in all patients, but were manageable. Although fatal treatment-related interstitial pneumonia occurred in 1 patient, other non-hematological toxicities were generally tolerable. Considering the markedly unfavorable characteristics of the included patients with advanced GCT who were intensively treated with cisplatin-based combination chemotherapies, IN could be regarded as having promising therapeutic activity with an acceptable toxicity profile.
    No preview · Article · Jun 2015 · International Journal of Clinical Oncology
  • Noritoshi Enatsu · Hideaki Miyake · Koji Chiba · Masato Fujisawa
    [Show abstract] [Hide abstract]
    ABSTRACT: Purpose To evaluate retrospectively the outcomes of microdissection testicular sperm extraction (micro-TESE) in men with nonobstructive azoospermia (NOA) and to identify the parameters predicting successful sperm retrieval in this cohort of patients. Methods After excluding patients with normal testicular volume and serum follicle-stimulating hormone (FSH) level who received conventional TESE, this study included 329 consecutive NOA patients undergoing micro-TESE at our institution. The significance of several factors, including age, testicular volume, etiology and serum levels of FSH, luteinizing hormone (LH) and serum testosterone (T), as predictors of successful sperm retrieval, was evaluated. Results Of the 329 men included in this series, 246 (74.8 %), 40 (12.2 %), and 43 (13.1 %) were pathologically diagnosed with Sertoli cell only, maturation arrest, and hypospermatogenesis, respectively. Spermatozoa were retrieved in 97 (29.5 %) of these 329 men by micro-TESE. Older age and non-idiopathic etiology were significantly associated with the probability of successful sperm retrieval; however, there were no significant effects of testicular volume as well as serum levels of FSH, LH, and T on sperm retrieval outcome. Furthermore, Johnsen score of the micro-TESE specimen showed a significant association with whether spermatozoa were successfully retrieved. Univariate analysis of preoperative parameters identified older age and non-idiopathic etiology as significant predictors of successful sperm retrieval, of which only etiology appeared to be independently related to successful sperm retrieval on multivariate analysis. Conclusions Spermatozoa are significantly less likely to be successfully retrieved by micro-TESE in men with idiopathic azoospermia.
    No preview · Article · Jun 2015 · Reproductive Medicine and Biology

Publication Stats

5k Citations
1,587.51 Total Impact Points


  • 1997-2015
    • Kobe University
      • • Division of Urology
      • • Department of Surgery
      Kōbe, Hyōgo, Japan
  • 2014
    • The Australian Society of Otolaryngology Head & Neck Surgery
      Evans Head, New South Wales, Australia
  • 2011
    • Institute for Molecular Medicine and Cell Therapy
      Düsseldorf, North Rhine-Westphalia, Germany
    • Government of the People's Republic of China
      Peping, Beijing, China
  • 2010
    • Hyogo Cancer Center
      Akasi, Hyōgo, Japan
  • 2008
    • Kyoto Prefectural University
      Kioto, Kyōto, Japan
    • Osaka City University
      • Department of Urology
      Ōsaka, Ōsaka, Japan
  • 2006
    • Vancouver General Hospital
      Vancouver, British Columbia, Canada
  • 2003-2005
    • Kawasaki Medical University
      • Department of Urology
      Kurasiki, Okayama, Japan
    • Yokohama Ekisaikai Hospital
      Yokohama, Kanagawa, Japan